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## REFERENCES (Include at least three persons living in the United States or Territories of the United States who are best qualified TO KNOW YOU AND WHO HAVE BEEN IN A POSITION TO KNOW of your qualifications AND for the position for which you are applying. Do not repeat names of supervisors.)| FULL NAME        | PRESENT BUSINESS HOME ADDRESS (Give complete street address) | BUSINESS OR OCCUPATION         || ---------------- | ------------------------------------------------------------ | ------------------------------ || 1. Norman Armour | c/o Dept. of State                                           | Former Ambassador to Venezuela || 2. F.S. Fitton   | c/o Dept. of State                                           | FSO                            || 3. R.C. Getty    | c/o Dept. of State                                           | FSO                            |INDICATE ANSWER BY PLACING "X" IN PROPER COLUMN| INDICATE ANSWER BY PLACING "X" IN PROPER COLUMN                                                                                                                                                                                                                                                                                                                                                                                       | YES | NO  || ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- | --- || 22. (a) Are you a citizen of the United States of America; or                                                                                                                                                                                                                                                                                                                                                                         | X   |     || (b) is a native of American Samoa or do you owe allegiance to the United States of America?                                                                                                                                                                                                                                                                                                                                           |     |     || 26. May inquiry be made of your present employers regarding your character, traits, capabilities, qualifications, etc?                                                                                                                                                                                                                                                                                                                | X   |     || 23. Are you now, or have you ever been, a member of the Communist Party, U.S.A., or any                                                                                                                                                                                                                                                                                                                                               |     | X   || 27. Do you now receive or have you ever received life annuity from the United States in Disability Retirement pay or compensation for military or naval service?                                                                                                                                                                                                                                                                      |     | X   || 24. Are you now, or have you ever been, a member of any foreign or domestic organization, association, movement, group, or combination of persons which is totalitarian, fascist, communist, subversive, or which advocates or approves the commission of acts of force or violence to deny other persons their rights under the law of the United States to overthrow the government of the United States by unconstitutional means? |     | X   || 28. Are you now an official or employee of any State, Territory, dependency, or municipality?                                                                                                                                                                                                                                                                                                                                         |     | X   || If your answer to question 23, 24, or 25 above is "Yes," state on a separate sheet to be attached to and made a part of this application the nature of the organization, association, movement, group, or combination of persons and dates of your membership, giving complete details of your activities, including your membership or association therein.                                                                          |     |     || 29. Have you ever been discharged from employment because: (1) Your conduct was unsatisfactory?                                                                                                                                                                                                                                                                                                                                       |     | X   || (2) Your work was not satisfactory?                                                                                                                                                                                                                                                                                                                                                                                                   |     | X   || 25. Does the United States Government employ in a civilian capacity any relative of yours by blood or marriage with whom you live as home and support as a dependent?                                                                                                                                                                                                                                                                 | X   |     || A. Have you ever resigned after official notification that: (1) Your conduct was not satisfactory?                                                                                                                                                                                                                                                                                                                                    |     | X   || If your answer is "Yes", give date of birth and name and address of relative (if any) Department or agency in which employed, and his kind of appointment.                                                                                                                                                                                                                                                                            |     |     || (2) Your work was not satisfactory?                                                                                                                                                                                                                                                                                                                                                                                                   |     | X   || C. Have you ever been discharged from the Armed Services under other than honorable conditions?                                                                                                                                                                                                                                                                                                                                       |     | X   || 31. A. Have you any physical handicap, chronic disease, or other disability?                                                                                                                                                                                                                                                                                                                                                          | X   |     || If your answer to A, B, or C is "Yes", give details in Item 34 attaching the name and address of every person who has pronounced, diagnosed, or treated your condition, including its nature and extent, and reason in each case.                                                                                                                                                                                                     |     |     || B. Have you ever had a nervous breakdown?                                                                                                                                                                                                                                                                                                                                                                                             | X   |     || C. Have you ever had tuberculosis?                                                                                                                                                                                                                                                                                                                                                                                                    | X   |     |34. SPACE FOR DETAILED ANSWERS TO OTHER QUESTIONSItem No. 17: China, 1933-37: Painting with U.S.N.Venezuela, 1949-52: Foreign Service.Ecuador, 1952-54: Foreign ServiceATTENTION: Read the statements below carefully before signing. Your answer to each question must be true and complete. A false answer or evasion may be grounds for non-consideration, or separation after appointment.I CERTIFY that the statements made by me on this application are true, complete, and correct to the best of my knowledge and belief, and are made in good faith.Date 10 February 1956Signature of applicant Robert T. Shaw